Ellisor, Glenn D
Ellisor, Glenn D is an sole proprietor health care provider with primary practice located at 1714 Kingwood Dr , Kingwood TX 77339-3046. He recently has only one registered license in Eye and Vision Services Providers / Corneal and Contact Management, which is considered as his primary health care specialty. Ellisor, Glenn D can be contacted via phone (281) 359-2020.Contact Information
Primary practice address
1714 Kingwood Dr
Kingwood TX 77339-3046
Phone: (281) 359-2020
Fax: (281) 359-7019
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | 03337TG | Texas |
Profile Details
| NPI number | 1407900590 |
|---|---|
| LBN Legal business name | Ellisor, Glenn D |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 23rd, 2007 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407900590 | NPPES |
| Texas | Other | 81071Q | BLUE CROSS |
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